The Utility of Ultrasound and Magnetic Resonance Imaging versus Surgery for the Characterization of Müllerian Anomalies in the Pediatric and Adolescent Population

Study ObjectiveTo evaluate the utility of transabdominal ultrasound and magnetic resonance imaging in the evaluation of American Society for Reproductive Medicine †(ASRM)-classified müllerian anomalies compared to surgical findings in the pediatric and adolescent population.DesignRetrospective chart review.SettingTertiary academic center.ParticipantsThirty-eight patients with müllerian anomalies seen in our pediatric and adolescent gynecology clinic were identified both on the basis of ICD-9 codes and having magnetic resonance imaging at Texas Children's Hospital between 2004 and 2009.InterventionsNone.Main Outcomes MeasureCorrelation among transabdominal ultrasound and magnetic resonance imaging findings with surgical findings.ResultsMean age was 12.2 (± 4.1) years. Twenty-eight patients underwent magnetic resonance imaging and required surgical intervention, and 88.5% demonstrated correlative consistency with surgical findings. Twenty-two patients underwent ultrasound, magnetic resonance imaging, and surgery, which revealed consistency among ultrasound and surgical findings (59.1%) and consistency among magnetic resonance imaging and surgical findings (90.9%). In ASRM diagnoses evaluated by magnetic resonance imaging, surgical findings correlated in 92% (Pearson 0.89). Overall, 55.2% of patients had a renal malformation.ConclusionsMagnetic resonance imaging is the gold standard imaging modality for müllerian anomalies and is an effective technique for noninvasive evaluation and accurate classification of the type of anomaly in the pediatric and adolescent population. Magnetic resonance imaging should be considered as an adjunct to transabdominal ultrasound to evaluate müllerian anomalies.